肺移植术后急性住院患者坐立试验的效用。
The Utility of the Sit-to-Stand Test for Inpatients in the Acute Hospital Setting After Lung Transplantation.
机构信息
Physiotherapy Department, The Alfred, Alfred Health, Philip Block, Level 4, 55 Commercial Road, Melbourne, Victoria, Australia 3004, and School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, Victoria Australia.
Physiotherapy Department, The Alfred, Alfred Health.
出版信息
Phys Ther. 2020 Jul 19;100(7):1217-1228. doi: 10.1093/ptj/pzaa057.
OBJECTIVE
Measurement of physical function is important to guide physical therapy for patients post-lung transplantation (LTx). The Sit-to-Stand (STS) test has proven utility in chronic disease, but psychometric properties post-LTx are unknown. The study aimed to assess reliability, validity, responsiveness, and feasibility of the 60-second STS post-LTx.
METHODS
This was a measurement study in 62 inpatients post-LTx (31 acute postoperative; 31 medical readmissions). Interrater reliability was assessed with 2 STS tests undertaken by different assessors at baseline. Known group validity was assessed by comparing STS repetitions in postoperative and medical groups. Content validity was assessed using comparisons to knee extensor and grip strength, measured with hand-held dynamometry. Criterion validity was assessed by comparison of STS repetitions and 6-minute walk distance postoperatively. Responsiveness was assessed using effect sizes over inpatient admission.
RESULTS
Median (interquartile range) age was 62 (56-67) years; time post-LTx was 5 (5-7) days postoperative and 696 (244-1849) days for medical readmissions. Interrater reliability was excellent (intraclass correlation coefficient type 2,1 = 0.96), with a mean learning effect of 2 repetitions. Repetitions were greater for medical at baseline (mean 18 vs 8). More STS repetitions were associated with greater knee extensor strength (postoperative r = 0.57; medical r = 0.47) and 6-minute walk distance (postoperative r = 0.68). Effect sizes were 0.94 and 0.09, with a floor effect of 23% and 3% at baseline (postoperative/medical) improving to 10% at discharge. Patients incapable of attempting a STS test were excluded, reducing generalizability to critical care. Physical rehabilitation was not standardized, possibly reducing responsiveness.
CONCLUSIONS
The 60-second STS demonstrated excellent interrater reliability and moderate validity and was responsive to change postoperatively.
IMPACT
The 60-second STS represents a safe, feasible functional performance tool for inpatients post-LTx. Two tests should be completed at each time point.
目的
测量身体机能对于指导肺移植（LTx）后患者的物理治疗非常重要。坐站（STS）测试已被证明在慢性病中有实用价值，但 LTx 后的心理测量特性尚不清楚。本研究旨在评估 LTx 后 60 秒 STS 的可靠性、有效性、反应性和可行性。
方法
这是一项 62 名 LTx 后住院患者（31 例急性术后；31 例医疗再入院）的测量研究。通过两名不同评估者在基线时进行两次 STS 测试来评估组内可靠性。通过比较术后组和医疗组的 STS 重复次数来评估已知组的有效性。通过与手持式测力计测量的膝关节伸肌和握力进行比较来评估内容有效性。通过比较术后 STS 重复次数和 6 分钟步行距离来评估标准有效性。通过住院期间的效应量来评估反应性。
结果
中位（四分位间距）年龄为 62（56-67）岁；LTx 后时间为术后 5（5-7）天和医疗再入院 696（244-1849）天。组内可靠性极好（2 型组内相关系数，1 = 0.96），平均学习效应为 2 次重复。基线时医疗组的重复次数更多（平均 18 次对 8 次）。STS 重复次数与膝关节伸肌力量更大（术后 r = 0.57；医疗 r = 0.47）和 6 分钟步行距离呈正相关（术后 r = 0.68）。效应量分别为 0.94 和 0.09，基线时存在 23%和 3%的地板效应（术后/医疗），出院时降至 10%。无法进行 STS 测试的患者被排除在外，降低了对重症监护的推广性。身体康复没有标准化，可能会降低反应性。
结论
60 秒 STS 显示出极好的组内可靠性和中等有效性，并且对术后有反应。
影响
60 秒 STS 是一种安全、可行的 LTx 后住院患者的功能性表现工具。每个时间点应完成两次测试。
Zotero 插件